From the Research
Quetiapine (Seroquel) can be effective for treating anxiety, though it's not FDA-approved specifically for anxiety disorders. It's typically used off-label for this purpose at lower doses (25-200 mg daily) than those used for approved conditions like schizophrenia or bipolar disorder. Quetiapine works by affecting multiple neurotransmitters including serotonin, dopamine, and histamine, which helps reduce anxiety symptoms. Some key points to consider when using quetiapine for anxiety include:
- It may be particularly helpful for patients who haven't responded to first-line treatments like SSRIs or benzodiazepines, or for those with comorbid conditions like insomnia or bipolar disorder.
- Common side effects include sedation, dizziness, weight gain, and metabolic changes, which should be monitored 1.
- Treatment typically begins with a low dose (25-50 mg) at bedtime, which may be gradually increased based on response and tolerability.
- Patients should know that sedation is common, especially when starting treatment, so the medication is often taken at night.
- While effective for some patients, quetiapine should be considered after trying standard anxiety treatments due to its side effect profile, and the decision to use it should be made in consultation with a healthcare provider who can weigh individual risks and benefits. A study from 2013 compared quetiapine to other atypical antipsychotics for schizophrenia, and found that quetiapine may produce fewer parkinsonian effects than some other medications, but may also produce greater weight gain and sedation 2. Another study from 2018 compared the efficacy of benzodiazepines and serotonergic antidepressants for generalized anxiety disorder, and found that benzodiazepines were the most effective treatment, but also noted that quetiapine may be useful for patients who have not responded to first-line treatments 3. Overall, the decision to use quetiapine for anxiety should be made on a case-by-case basis, taking into account the individual patient's symptoms, medical history, and potential risks and benefits. Some other studies have also investigated the use of quetiapine for anxiety, including a study from 2008 that reviewed the use of combination treatment with benzodiazepines and SSRIs for comorbid anxiety and depression 4, and a study from 2013 that compared the effectiveness of quetiapine, risperidone, and olanzapine as adjunctive treatments for major depression with psychotic features 5.